Serum Lipid Profiles, Blood Glucose, and High-Sensitivity C-Reactive Protein Levels Among People Living with HIV Taking Dolutegravir and Ritonavir-Boosted Atazanavir-Based Antiretroviral Therapy at Jimma University Medical Center, Southwest Ethiopia, 2021

Abstract

Nuredin Chura Waritu,1 Suresh Kumar P Nair,2 Bihonegn Birhan2 ,† Tesfaye Adugna,2 Gesese Bogale Awgichew,2 Mohammed Jemal3 1Department of Biomedical Sciences, School of Medicine, Wolaita Sodo University, Wolaita Sodo, Ethiopia; 2Department of Biomedical Sciences, School of Medicine, Jimma University, Jimma, Ethiopia; 3Department of Biomedical Sciences, School of Medicine, Debre Markos University, Debre Markos, Ethiopia†Bihonegn Birhan passed away on [September 19, 2023]Correspondence: Mohammed Jemal, Email [email protected]: Long-term use of antiretroviral therapy, especially dolutegravir and boosted-atazanavir, raises concerns about cardiovascular disease. Thus, this study aimed to assess lipid profiles, blood glucose, and high-sensitivity C-reactive protein levels among people living with HIV on dolutegravir and ritonavir-boosted atazanavir-based therapy.Methods: An institutional-based comparative cross-sectional study was conducted from November 4, 2021, to January 4, 2022. An equal number of dolutegravir- and ritonavir-boosted atazanavir-treated patients (n = 64 each) was enrolled. A consecutive sampling was used to select participants. The Chi-square, Student’s t-test, Mann–Whitney U-test, and logistic regression were used as appropriate statistical tests using SPSS Version 25.0. Statistical significance was set at p 40 years were predictors of dyslipidemia, while BMI ≥ 25 kg/m2 (AOR=3.7, 95% CI: 1.3, 10.8) and dolutegravir-based regimens (AOR=4.6, 95% CI: 1.5, 14) were predictors of hyperglycemia. Ritonavir-boosted atazanavir-based regimens (ARR=3, 95% CI: 1.3, 8) and BMI ≥ 25 kg/m2 (ARR=2.5, 95% CI: 1.1, 6) were associated with increased high-sensitivity C-reactive protein by 1– 3 mg/L. The risk of increased high-sensitivity C-reactive protein by > 3 mg/L was greater in those patients with a CD4 cell count of < 500 cells/mm3 (ARR=5, 95% CI: 1.1, 24).Conclusion: When compared to ritonavir-boosted atazanavir-based regimens, dolutegravir had favorable lipid profiles and high-sensitivity C-reactive protein but unfavorable blood glucose levels. Therefore, baseline blood glucose, lipid profiles, and high-sensitivity C-reactive protein levels should be routinely measured in patients on these regimens.Keywords: high-sensitivity C-reactive protein, dolutegravir, dyslipidemia, hyperglycemia, antiretroviral therapy

Keywords

• high sensitivity c reactive protein
• dolutegravir
• dyslipidemia
• hyperglycemia
• antiretroviral therapy